Abstract:

To perform the traditional Kocher maneuver for retroperitoneal lymph node dissection. Transect the jejunum 5-10 cm away from the ligament of Treitz, transect the distal 2/3 of gastric body, to dissect and skeletonize the hepatoduodenal ligament, to cut off the GDA, and pancreatic neck. Then to dissect the lymph nodes around common hepatic artery and celiac trunk. To divide the SMA-CT system and to dissect its right and left side around 360. Remove the total mesentery of pancreatic uncinate process. To resect the gallbladder and transect the common hepatic duct finally. To check the surgical site with extended lymph node dissection of 8p 9 12a 12p 14c-d 16a2 16b1 groups. Pancreaticojejunostomy was performed by using innovative "two-point" pancreatic duct-mucosal anastomosis. Choledochojejunostomy was performed by Continuous suture. Gastrointestinal anastomosis was performed with Endo-GIA.

Key words: Pancreaticoduodenectomy, Laparoscopes, Lymph node excision